Infliximab, methotrexate and their combination for the treatment of rheumatoid arthritis: a systematic review and meta-analysis
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1016/j.rbr.2014.10.009 http://repositorio.unifesp.br/handle/11600/38788 |
Resumo: | We performed a systematic review to evaluate the efficacy and safety of infliximab + methotrexate (IFX + MTX) regimens versus MTX alone or in combination with other disease-modifying anti-rheumatic drugs (DMARDs). We searched through major databases, the grey literature and did a manual search. Two independent reviewers conducted the selection, data extraction and analysis of the quality of the studies. Meta-analysis was conducted using Review Manager (R) 5.1 software. Nine trials were included. the mean modified Jadad score was 4.4, but only one study showed low risk of bias. IFX + MTX regimen presented better responses in clinical outcomes of ACR and DA528 by up to 54 weeks, and of radiographic progression by up to 104 weeks. Withdrawals due to lack of efficacy was lower in the IFX + MTX group. No significant difference in adverse events was observed. the IFX + MTX combination is more effective than treatment with MTX alone or DMARDs combination. This regimen presented good tolerability in patients previously treated with DMARDs, not treated with MTX or with insufficient responses to MTX. the efficacy of IFX + MTX is noted primarily during initial periods of treatment. High doses of IFX were as effective as the standard dose, but with possible higher risk of serious infections. Therefore, we advise clinicians to use the standard dose of IFX 3 mg/kg every 8 weeks. (C) 2013 Elsevier Editora Ltda. All rights reserved. |
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Infliximab, methotrexate and their combination for the treatment of rheumatoid arthritis: a systematic review and meta-analysisInfliximabSystematic reviewMeta-analysisRheumatoid arthritisEfficacyWe performed a systematic review to evaluate the efficacy and safety of infliximab + methotrexate (IFX + MTX) regimens versus MTX alone or in combination with other disease-modifying anti-rheumatic drugs (DMARDs). We searched through major databases, the grey literature and did a manual search. Two independent reviewers conducted the selection, data extraction and analysis of the quality of the studies. Meta-analysis was conducted using Review Manager (R) 5.1 software. Nine trials were included. the mean modified Jadad score was 4.4, but only one study showed low risk of bias. IFX + MTX regimen presented better responses in clinical outcomes of ACR and DA528 by up to 54 weeks, and of radiographic progression by up to 104 weeks. Withdrawals due to lack of efficacy was lower in the IFX + MTX group. No significant difference in adverse events was observed. the IFX + MTX combination is more effective than treatment with MTX alone or DMARDs combination. This regimen presented good tolerability in patients previously treated with DMARDs, not treated with MTX or with insufficient responses to MTX. the efficacy of IFX + MTX is noted primarily during initial periods of treatment. High doses of IFX were as effective as the standard dose, but with possible higher risk of serious infections. Therefore, we advise clinicians to use the standard dose of IFX 3 mg/kg every 8 weeks. (C) 2013 Elsevier Editora Ltda. All rights reserved.Univ Fed Minas Gerais, Fac Med, Programa Posgrad Saude Publ, Belo Horizonte, MG, BrazilUniv Fed Minas Gerais, Fac Med, Programa Pos Grad Med & Assistencia Farmaceut, Belo Horizonte, MG, BrazilUniv Fed Minas Gerais, Fac Med, Dept Farmacia Social, Belo Horizonte, MG, BrazilUniv Fed Minas Gerais, Fac Med, Dept Sistema Locomotor, Belo Horizonte, MG, BrazilUniversidade Federal de São Paulo, Med Baseada Evidencias PGMIT, São Paulo, SP, BrazilUniv Fed Minas Gerais, Fac Med, Dept Prevent & Social Med, Belo Horizonte, MG, BrazilUniversidade Federal de São Paulo, Med Baseada Evidencias PGMIT, São Paulo, SP, BrazilWeb of ScienceElsevier B.V.Universidade Federal de Minas Gerais (UFMG)Universidade Federal de São Paulo (UNIFESP)Costa, Juliana de OliveiraLemos, Livia Lovato Pires deMachado, Marina Amaral de ÁvilaAlmeida, Alessandra MacielKakehasi, Adriana MariaAraújo, Vania de Eloisa [UNIFESP]Cherchiglia, Mariangela LealAndrade, Eli Iola GurgelAcúrcio, Francisco de Assis2016-01-24T14:40:06Z2016-01-24T14:40:06Z2015-03-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion146-158application/pdfapplication/pdfhttp://dx.doi.org/10.1016/j.rbr.2014.10.009Revista Brasileira de Reumatologia. New York: Elsevier B.V., v. 55, n. 2, p. 146-158, 2015.10.1016/j.rbr.2014.10.009S0482-50042015000200146-en.pdf|S0482-50042015000200146-pt.pdf0482-5004S0482-50042015000200146http://repositorio.unifesp.br/handle/11600/38788WOS:000352510000007porRevista Brasileira de Reumatologiainfo:eu-repo/semantics/openAccesshttp://www.elsevier.com/about/open-access/open-access-policies/article-posting-policyreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-08-01T06:40:25Zoai:repositorio.unifesp.br/:11600/38788Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-08-01T06:40:25Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Infliximab, methotrexate and their combination for the treatment of rheumatoid arthritis: a systematic review and meta-analysis |
title |
Infliximab, methotrexate and their combination for the treatment of rheumatoid arthritis: a systematic review and meta-analysis |
spellingShingle |
Infliximab, methotrexate and their combination for the treatment of rheumatoid arthritis: a systematic review and meta-analysis Costa, Juliana de Oliveira Infliximab Systematic review Meta-analysis Rheumatoid arthritis Efficacy |
title_short |
Infliximab, methotrexate and their combination for the treatment of rheumatoid arthritis: a systematic review and meta-analysis |
title_full |
Infliximab, methotrexate and their combination for the treatment of rheumatoid arthritis: a systematic review and meta-analysis |
title_fullStr |
Infliximab, methotrexate and their combination for the treatment of rheumatoid arthritis: a systematic review and meta-analysis |
title_full_unstemmed |
Infliximab, methotrexate and their combination for the treatment of rheumatoid arthritis: a systematic review and meta-analysis |
title_sort |
Infliximab, methotrexate and their combination for the treatment of rheumatoid arthritis: a systematic review and meta-analysis |
author |
Costa, Juliana de Oliveira |
author_facet |
Costa, Juliana de Oliveira Lemos, Livia Lovato Pires de Machado, Marina Amaral de Ávila Almeida, Alessandra Maciel Kakehasi, Adriana Maria Araújo, Vania de Eloisa [UNIFESP] Cherchiglia, Mariangela Leal Andrade, Eli Iola Gurgel Acúrcio, Francisco de Assis |
author_role |
author |
author2 |
Lemos, Livia Lovato Pires de Machado, Marina Amaral de Ávila Almeida, Alessandra Maciel Kakehasi, Adriana Maria Araújo, Vania de Eloisa [UNIFESP] Cherchiglia, Mariangela Leal Andrade, Eli Iola Gurgel Acúrcio, Francisco de Assis |
author2_role |
author author author author author author author author |
dc.contributor.none.fl_str_mv |
Universidade Federal de Minas Gerais (UFMG) Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Costa, Juliana de Oliveira Lemos, Livia Lovato Pires de Machado, Marina Amaral de Ávila Almeida, Alessandra Maciel Kakehasi, Adriana Maria Araújo, Vania de Eloisa [UNIFESP] Cherchiglia, Mariangela Leal Andrade, Eli Iola Gurgel Acúrcio, Francisco de Assis |
dc.subject.por.fl_str_mv |
Infliximab Systematic review Meta-analysis Rheumatoid arthritis Efficacy |
topic |
Infliximab Systematic review Meta-analysis Rheumatoid arthritis Efficacy |
description |
We performed a systematic review to evaluate the efficacy and safety of infliximab + methotrexate (IFX + MTX) regimens versus MTX alone or in combination with other disease-modifying anti-rheumatic drugs (DMARDs). We searched through major databases, the grey literature and did a manual search. Two independent reviewers conducted the selection, data extraction and analysis of the quality of the studies. Meta-analysis was conducted using Review Manager (R) 5.1 software. Nine trials were included. the mean modified Jadad score was 4.4, but only one study showed low risk of bias. IFX + MTX regimen presented better responses in clinical outcomes of ACR and DA528 by up to 54 weeks, and of radiographic progression by up to 104 weeks. Withdrawals due to lack of efficacy was lower in the IFX + MTX group. No significant difference in adverse events was observed. the IFX + MTX combination is more effective than treatment with MTX alone or DMARDs combination. This regimen presented good tolerability in patients previously treated with DMARDs, not treated with MTX or with insufficient responses to MTX. the efficacy of IFX + MTX is noted primarily during initial periods of treatment. High doses of IFX were as effective as the standard dose, but with possible higher risk of serious infections. Therefore, we advise clinicians to use the standard dose of IFX 3 mg/kg every 8 weeks. (C) 2013 Elsevier Editora Ltda. All rights reserved. |
publishDate |
2015 |
dc.date.none.fl_str_mv |
2015-03-01 2016-01-24T14:40:06Z 2016-01-24T14:40:06Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1016/j.rbr.2014.10.009 Revista Brasileira de Reumatologia. New York: Elsevier B.V., v. 55, n. 2, p. 146-158, 2015. 10.1016/j.rbr.2014.10.009 S0482-50042015000200146-en.pdf|S0482-50042015000200146-pt.pdf 0482-5004 S0482-50042015000200146 http://repositorio.unifesp.br/handle/11600/38788 WOS:000352510000007 |
url |
http://dx.doi.org/10.1016/j.rbr.2014.10.009 http://repositorio.unifesp.br/handle/11600/38788 |
identifier_str_mv |
Revista Brasileira de Reumatologia. New York: Elsevier B.V., v. 55, n. 2, p. 146-158, 2015. 10.1016/j.rbr.2014.10.009 S0482-50042015000200146-en.pdf|S0482-50042015000200146-pt.pdf 0482-5004 S0482-50042015000200146 WOS:000352510000007 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
Revista Brasileira de Reumatologia |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy |
eu_rights_str_mv |
openAccess |
rights_invalid_str_mv |
http://www.elsevier.com/about/open-access/open-access-policies/article-posting-policy |
dc.format.none.fl_str_mv |
146-158 application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier B.V. |
publisher.none.fl_str_mv |
Elsevier B.V. |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268350267654144 |